WEST SOMERVILLE DENTAL
NPI: 1518269810
· SOMERVILLE, MA 02144
· Periodontist
· NPI assigned 11/19/2010
$163K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: ALVI-SHAH, MARHAMA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,079 |
$37K |
| 2019 |
687 |
$24K |
| 2020 |
498 |
$16K |
| 2021 |
693 |
$25K |
| 2022 |
638 |
$24K |
| 2023 |
485 |
$18K |
| 2024 |
442 |
$19K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,800 |
1,702 |
$88K |
| D0120 |
Periodic oral evaluation - established patient |
1,873 |
1,793 |
$42K |
| D0274 |
Bitewings - four radiographic images |
252 |
236 |
$9K |
| D1120 |
Prophylaxis - child |
205 |
191 |
$8K |
| D1208 |
Topical application of fluoride, excluding varnish |
254 |
237 |
$7K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
76 |
37 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
25 |
24 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
37 |
36 |
$1K |